Effect Of Immunohistochemical GPC-3 Combined With Serum Markers In The Diagnosis Of Hepatocellular Carcinoma

Background and Objective:In China,the most economical and convenient method for early diagnosis of primary and secondary hepatocellular carcinoma is the detection and screening of serological markers.However,due to the significant differences in sensitivity and specificity of different serum markers,it is difficult to make an accurate diagnosis.Gpc-3 is a relatively sensitive immunomarker,but there are differences in patients with different disease conditions.Gpc-3 was detected by histopathology and immunohistochemistry of biopsy histological samples of early tumors and combined with serological marker detection to comprehensively analyze the types and diagnostic effects of liver cancer in patients.To provide help for differential follow-up treatment of patients with primary and secondary liver cancer.This study was to investigate the role of immunohistochemical GPC-3 combined with serological markers in the early diagnosis and differential diagnosis of primary and secondary hepatocellular carcinoma.Method:120 patients with hepatocellular carcinoma in our hospital(60 cases of primary hepatocellular carcinoma and 60 cases of secondary hepatocellular carcinoma)and 60 physical screening patients who underwent puncture diagnosis due to liver nodules in the same period were selected as samples for retrospective analysis.Collect corresponding data for analysis.The patients were divided into primary hepatocellular carcinoma group,secondary l hepatocellular carcinoma group and control group.The puncture samples of the three groups of patients were made routine immunohistochemical section,stained,observed under the microscope for tissue morphology and GPC-3 expression,and the results were interpreted by two doctors with senior professional titles;The concentrations of alpha fetoprotein(AFP),carcinoembryonic antigen(CEA),carbohydrate antigen 19-9(CA19-9)and ferritin(ferritin)in serum samples of the three groups were detected by automatic chemiluminescence detector with matching reagents.Result:(1)The positive expression of GPC-3 in control group,primary hepatocellular carcinoma group and secondary hepatocellular carcinoma group were 28.33%,88.33%and 0.00% respectively.The total positive rate was significantly different(P <0.001).(2)The sensitivity,specificity,accuracy,and Yuden index of GPC-3 in the diagnosis of primary hepatocellular carcinoma were 88.33%,85.83%,86.67%,and0.7420,respectively.The sensitivity,specificity,accuracy,and Yuden index of GPC-3in the diagnosis of secondary hepatocellular carcinoma were 100.00%,58.33%,58.33%,and 0.5833,respectively.(3)The optimal conditions for single or combined detection of AFP,CEA,CA19-9,and Ferrer serum markers to diagnose primary and secondary hepatocellular carcinoma are as follows: The sensitivity(78.33%),specificity(90.00%),accuracy(86.11%)and Yuden index(0.6833)of AFP in the diagnosis of primary hepatocellular carcinoma;The sensitivity(75.00%),specificity(55.83%),accuracy(62.22%)and Yuden index(0.3083)of CEA+CA19-9 in the diagnosis of secondary hepatocellular carcinoma;(4)The optimal conditions of GPC-3 positive combined with serum AFP,CEA,CA19-9 and Ferrer for the diagnosis of primary and secondary hepatocellular carcinoma are as follows: The sensitivity(92.45%),specificity(100.00%),accuracy(94.29%)and Yuden index(0.9245)of GPC-3 positive combined with CEA+ CA19-9in the diagnosis of primary hepatocellular carcinoma;The sensitivity(85.71%),specificity(83.33%),accuracy(83.43%)and Yuden index(0.6905)of GPC-3 negative combined with Ferrer in the diagnosis of primary l hepatocellular carcinoma,and the sensitivity(75.00%),specificity(92.00%),accuracy(82.73%)and Yuden index(0.6700)of GPC-3 negative combined with CEA+CA19-9 in the diagnosis of secondary hepatocellular carcinoma.Conclusion:(1)The specificity,accuracy,and Yuden index of GPC-3 in diagnosing primary hepatocellular carcinoma were better than those of GPC-3 in diagnosing secondary hepatocellular carcinoma.(2)GPC-3 immunohistochemistry combined with serum CEA+CA19-9 could significantly improve the diagnostic efficiency of primary and secondary hepatocellular carcinoma,and has a positive significance for the implementation of the follow-up targeted treatment.